PURPOSE: Sonographic reports are examiner-dependent and may not always be reliable. We investigated concordance between documented findings and diagnostic conclusions--not the objective correctness of both--with the help of a knowledge-based documentation system. MATERIALS AND METHODS: The knowledge-based documentation system SonoConsult (SC) is routinely used in the ultrasound unit of a ...

OBJECTIVE: To evaluate the FocalPoint Location-Guided Screening (FPGS) performance in computer-assisted primary screening of Papanicolaou-stained cervicovaginal smears. STUDY DESIGN: A total of 37,306 routine consecutive conventional Pap slides were prospectively processed on the FPGS. Each slid designated by the instrument as Review was reported according to results obtained using a ...

To assess the feasibility, including diagnostic accuracy and time cost, of a real-time telepathology system with pathologic slides, 600 cases covering a wide spectrum of lesions from 16 organ systems were tested. The "correct" diagnosis (gold standard) was established as a consensus by 2 experienced pathologists. The cases were first ...

PURPOSE: The association between psychological difficulties and accommodative insufficiency in children and young adults has been previously reported. The authors give their experiences with such cases and address the research and service developments required to deal with these problems. METHODS: When no other organic pathology was found in full ophthalmological ...

KR-21 provides a lower limit for the computed value of KR-20. KR-20 is equivalent to coefficient alpha when a test is composed of dichotomous items scored 0 or 1. Therefore, KR-21 coefficients, computed from simple summary statistics, can be used in cases in which journal authors do not provide the ...

We wished to compare the relative reproducibility and validity of cervical intraepithelial neoplasia (CIN) 2 and CIN3 diagnoses. In a population-based cohort study (1993-2001) of human papillomavirus (HPV) and cervical neoplasia in Costa Rica, we compared community pathologists' diagnoses with those of the 2 independent reviewers from the United States ...

Excavations at Guilá Naquitz and Silvia's Cave, two dry rockshelters near Mitla, Oaxaca, Mexico, yielded the remains of 122 chili peppers dating to the period A.D. 600-1521. The chilies can be assigned to at least 10 cultivars, all belonging to the species Capsicum annuum or Capsicum frutescens. The specimens are ...

BACKGROUND: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. PURPOSE: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. MATERIAL ...

OBJECTIVE: The quality of clinical care is often assessed by retrospective examination of case-notes (charts, medical records). Our objective was to determine the inter-rater reliability of case-note audit. METHODS: We conducted a systematic review of the inter-rater reliability of case-note audit. Analysis was restricted to 26 papers reporting comparisons of ...

OBJECTIVE: To evaluate the quality of reporting of diagnostic accuracy studies using optical coherence tomography (OCT) in glaucoma. DESIGN: Descriptive series of published studies. PARTICIPANTS: Published studies reporting a measure of the diagnostic accuracy of OCT for glaucoma. METHODS: Review of English language papers reporting measures of diagnostic accuracy of ...

OBJECTIVES: Adverse events (AEs) are poor patient outcomes, resulting from medical care. We performed this study to quantify the misclassification rate obtained using current AE detection methods and to evaluate the effect of combining physician AE ratings. STUDY DESIGN AND SETTING: Three physicians independently rated poor patient outcomes. We used ...

An environmental risk assessment (ERA) was made for the common nonsteroidal anti-inflammatory drug naproxen. The ERA was performed according to deterministic and probabilistic methods, based on different predicted environmental concentrations (PECs) and measured environmental concentrations (MECs) on the exposure side as well as on published and newly elaborated acute ecotoxicity ...

To compare two approaches to analysing energy- and nutrient-converted data from dietary validation (and relative validation) studies - conventional analyses, in which the accuracy of reported items is not ascertained, and reporting-error-sensitive analyses, in which reported items are classified as matches (items actually eaten) or intrusions (items not actually eaten), ...

Kawasaki disease also known as mucocutaneous lymph node syndrome is a generalised vasculitis of unknown etiology. Presenting a review of the literature and using our cases for illustration we discuss some of the pertinent features in the evaluation and management of patients with this condition. 2 cases of Kawasaki disease ...

Spontaneous renal artery dissection (SRAD) is a relatively rare entity that has been described in several case reports and small series in the medical literature. The condition is best diagnosed with angiography, with renal ischemia or infarction a common complication. Conservative medical management, surgical intervention, and percutaneous intervention are all ...

Definitions of male condom failure modes are now well documented, and failure events are usually reported as the proportion of the total number of condoms used and the proportion of men/couples who experience an event. The lack of standardized definitions for female condom (FC) failure has led to variability in ...

Core needle biopsies (CNBs) of the breast are highly sensitive techniques for sampling of mammographic calcifications. Currently, there is no standardized protocol for evaluating such samples. This study was undertaken to attempt to standardize the procedure of correlating histologic findings with mammographically detectable calcification. 113 CNBs with mammographic evidence of ...

One of the concerns often voiced by critics of the precautionary principle is that a widespread regulatory application of the principle will lead to a large number of false positives (i.e., over-regulation of minor risks and regulation of nonexisting risks). The present article proposes a general definition of a regulatory ...

The treatment of amblyopia in children is frequently discussed in the literature. Less attention, however, has been given to the durability of the visual acuity results attained with therapy. The objective of this review is to conduct an in-depth analysis of the existing literature, on the stability of visual acuity ...

Research consistently indicates that jurors' intuitive prototypes of insanity and case-relevant attitudes shape their verdicts more strongly than legal definitions of insanity. Based on a sample of 113 prospective jurors, this study was designed to (a) assess the extent to which three prototypes of insanity held by jurors in a ...

This study compared Giemsa (GM) and methylene blue (MB) stains for the diagnosis of Helicobacter pylori. Gastric biopsy specimens obtained from January 2001 to December 2005 were reviewed. They were all stained with hematoxylin and eosin, GM and MB stains. The slides were examined on a blinded basis. Direct comparisons ...

Electronic decision support systems are an important tool for improving performance and improving quality of care. We investigated the relationship between physicians' estimated resolution times for computerized clinical reminders and adherence rates in VA outpatient settings. We surveyed 10 expert physician users to assess the resolution times of four targeted ...

BACKGROUND: Equivocal atypia in respiratory cytology can be a diagnostic challenge. In such cases fluorescence in situ hybridization (FISH) may be used for the analysis of chromosomal aberrations and often allows a reliable distinction of benign and malignant cells. METHODS: An online picture gallery of 30 respiratory cytologic preparations comprising ...

BACKGROUND: Management of dental caries demands early detection of carious lesions. This article provides an overview of the state-of-the-art methodologies for the detection and assessment of early carious lesions. TYPES OF STUDIES REVIEWED: The authors reviewed MEDLINE for available literature on new caries detection methodology and tools, using terms such ...

We sought to determine whether a group of cases that was relatively high in disagreements and subsequent amendments could be identified and targeted for blinded review. During a 4-year period, 8,916 surgical pathology and nongynecologic cytology cases were subjected to blinded review; of these, there were 616 disagreements (6.9%), 69 ...

BACKGROUND/PURPOSE: Neonatal screening using tandem mass spectrometry (MS/MS) started in Taiwan in 2000. We evaluated the efficacy of this system by analyzing the frequency of diseases and the outcome of the patients identified. METHODS: Between August 2001 and July 2004, 199, 922 neonates were screened for 10 amino acids and ...

OBJECTIVE: Aviation accidents have been reduced substantially by training pilots to avoid high-risk behaviors caused by cognitive errors. To determine whether similar cognitive cause factors or errors are involved in medical malpractice cases, and to evaluate the reliability of identifying such factors, physicians reviewed state and federal malpractice cases in ...

OBJECTIVE: To determine the observer variability in reporting fibroadenoma of the breast by fine needle aspiration (FNA) and to review the cytomorphological features of the lesion with cytohistological correlation. METHODS: Retrospective analysis of FNA smears from 110 cases diagnosed as fibroadenoma of which surgical pathology follow-up was available in 33. ...

To evaluate the performance characteristics of power Doppler ultrasound as a diagnostic and monitoring tool in the assessment of musculoskeletal disease through a systematic review of the literature. We performed a literature search of PUBMED (1966 to June 2005). Only original research reports written in English involving musculoskeletal disease and ...

OBJECTIVE: To explore the temporal characteristics of laboratory false negative reports in cervical cytology. STUDY DESIGN: The temporal characteristics of 198 false negative cervical cytology cases were compared with those of 750,805 control cases. RESULTS: The false negative rate did not vary significantly by month, day of the week or ...

The decision to substantiate a case of maltreatment is pivotal to myriad stakeholders; however, the reliability (and therefore, accuracy) of substantiation determinations is suspect. The authors tested if (a) they could develop more reliable substantiation definitions and processes and (b) case workers would be comfortable with and accepting of a ...

The objective of this study was to compare the results of the NIOSH, ACGIH TLV, Snook, 3DSSPP and WA L&I lifting assessment instruments when applied to a uniform task (lifting and lowering milk cases with capacities of 15 and 23l). To enable comparisons between the various lifting assessment instruments, the ...

Although several studies have examined the reliability of diagnosing delusions there is no comprehensive review of the literature. Therefore, the reliability of diagnosing 'delusions in general' and the subcategory of 'bizarre delusions' was reviewed, including both structured interview and standardized instrument methods. The literature suggests that delusions in general can ...

BACKGROUND: Excessive use of significant figures in numerical data gives a spurious impression of laboratory imprecision to clinicians. We describe reporting practices in 24 Asia-Pacific laboratories, assess whether these reporting formats and those used in the literature can be justified based on actual laboratory performance and outline how to choose ...

There is substantial heterogeneity with regard to influenza case definitions used in the medical literature. These different case definitions can vary substantially with regard to their sensitivity, specificity and positive and negative predictive values for confirmed influenza. Because of this heterogeneity, it is important that the appropriate case definitions be ...

To compare the use of Papanicolaou and Wright-Giemsa stains for the evaluation of body fluids in cytology and hematology laboratories and determine whether other factors account for discrepancies in diagnosis. We retrospectively reviewed cytopathology reports of peritoneal, pleural, and cerebrospinal fluids received by hematology and cytology laboratories for 1 year. ...

In gynecologic cytology, workload limits are imposed as a surrogate to limit error rates. Whether workload correlates with error rates in surgical pathology and nongynecologic cytology is not known. We reviewed and compared the disagreement and amendment rates based on blinded review for 5 pathologists with the number of cases ...

We report a technical improvement upon a previously disclosed manual liquid-based cytology (MLBC) method; and, we use the improved method to prepare slides from residual ThinPrep specimens in order to see how often ThinPrep diagnoses correspond to diagnoses derived from exhaustive examination of their parent sample suspensions. Residual cell suspensions ...

Despite numerous studies that measure self-reported condom use, there is currently no agreed upon "gold standard" in terms of the best way to assess condom use. The purpose of the current study was to review measures of self-reported condom use within correlational studies of sexual risk behavior, and to evaluate ...

OBJECTIVE: The purpose of this study is to examine the role of emotional reactivity (ER) in symptom reporting and conceptualize somatizing processes as a signal detection task. Emotional reactivity has been theorized to influence symptom reporting through somatic sensitivity as well as via a negative reporting style. We assess the ...

There is substantial variation in bull breeding soundness evaluation procedures and reports in Australia; the situation is compounded by difficulties in interpretation and the validity of many reports. In an effort to overcome this, the scientific literature was reviewed [Fordyce G. In: Fordyce G, editor. Bull fertility: selection and management ...

The Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) detail the requirements for the cytotechnologist (CT) who evaluates gynecologic cytopathology specimens. However, the role of the CT in nongynecologic cytopathology is not clearly defined. Furthermore, non gynecologic cytopathology cases are diverse and the screening, interpretative, and diagnostic issues may be ...

Assessment of human epidermal growth factor receptor-2 status is standard practice in women with breast cancer. Most laboratories use immunohistochemistry as a screening test, with equivocal results confirmed by fluorescence in-situ hybridization (FISH). Chromogenic in-situ hybridization (CISH) is a relatively new method for detection of gene amplification using a peroxidase ...